Adrienne J K Carmack, MD | |
703 E Marshall Ave, Suite 5007, Longview, TX 75601-5500 | |
(903) 315-4455 | |
(903) 315-2466 |
Full Name | Adrienne J K Carmack |
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Gender | Female |
Speciality | Urology |
Location | 703 E Marshall Ave, Longview, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346430527 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | N1275 (Texas) | Primary |
Entity Name | East Texas Functional Medicine Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245847672 PECOS PAC ID: 7911319496 Enrollment ID: O20201208001745 |
Mailing Address | Practice Location Address |
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Adrienne J K Carmack, MD Po Box 731218, Dallas, TX 75373-1218 Ph: (903) 315-4119 | Adrienne J K Carmack, MD 703 E Marshall Ave, Suite 5007, Longview, TX 75601-5500 Ph: (903) 315-4455 |
Dr. Paul Brian Williams, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 802 Medical Dr, Longview, TX 75605 Phone: 903-757-7871 Fax: 903-753-2479 | |
Landon Taylor Erickstad, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 802 Medical Dr Ste 400, Longview, TX 75605 Phone: 903-757-7871 Fax: 903-753-2479 | |
Dr. John M Ferrell, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 703 E Marshall Ave, Suite 5008, Longview, TX 75601 Phone: 903-757-7871 Fax: 903-753-2479 | |
Gid Roger Johnson, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 1608 Sweetbriar St, Longview, TX 75604 Phone: 903-297-6000 Fax: 903-297-6250 | |
Dr. Gregory Ashton Edwards, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 802 Medical Dr, Suite 400, Longview, TX 75605 Phone: 903-757-7871 Fax: 903-753-2479 | |
Dr. Timothy W Howes, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 703 E Marshall Ave, Suite 5008, Longview, TX 75601 Phone: 903-757-7871 Fax: 903-753-2479 |